This form should be completed with the information of the person/child receiving the vaccine. Appointments are required for each person requesting the vaccine.
Register for your COVID-19 vaccination appointment by selecting an appointment time and answering the questions below. All questions are required. Please register using your full legal name.
After completing the pre-registration, you will reach a confirmation message with a summary of the date, time, and location of your scheduled vaccination appointment. Please note these details and keep them for your records. Note: If you do not reach a confirmation page, it may mean that you skipped a question or the original appointment time you selected is no longer available. Please review/correct your answers to complete the appointment.
Please be aware that if vaccine shipment is delayed, we may need to cancel this appointment. You can check your email prior to the clinic to ensure no changes have been made to your appointment time. Appointment confirmation and reminder emails will come from email@example.com. Please check your junk/spam email folders.
Minors must have a parent/guardian present at the time of vaccination.
You will receive a text message reminder before your appointment